How To Help Teens Manage Their Anxiety

Anxiety in adolescents is on the rise, reports the New York Times: It is now the most common reason university students request counselling services, and numerous surveys indicate that kids in high school and university are feeling overburdened and overwhelmed. Hospital admissions for suicide attempts in the US have doubled in the last decade, and Times describes in-patient facilities for severely anxious teens.

Photo: Keirsten Marie

This is not a surprise to Dr Lynne Siqueland, a clinical psychologist at the Children's and Adult Center for OCD and Anxiety in Plymouth Meeting, Pennsylvania. "I work a lot with school counsellors, and they're saying that the numbers of students reporting anxiety have gone up, and they're reporting more severe anxiety."

Part of this is due to external factors: Kids living in precarious or unsafe circumstances might reasonably feel anxious about their security. Dr Siqueland tells me that counselling approaches for those students usually include practical advice that will reduce their chances of being harmed, such as walking home with a buddy if they're afraid to walk alone. But she also tells me that some of the highest rates of anxiety and depression are in upper-middle-class and upper-class kids, who are experiencing a "different kind of pressure. So many kids are being judged on their achievement only."

Knowing how to help a kid with anxiety is tough: Should you shield the child from all anxiety-inducing circumstances? Release them from school and family obligations? Intervene with teachers and coaches when it all gets to be too much?

Dr Siqueland offers counsel to caregivers in her parenting workshops, and she told me that she generally gives a few basic suggestions.

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Avoid Avoidance

"One of the most difficult decisions that comes with parenting an anxious teen is how much to push and how much to help," says Dr Siqueland. She tells parents to avoid avoidance. "Don't let your kid not do the things they need to do to succeed [socially and academically], like talk to friends and teachers and explore independently." If your kid is avoiding things out of anxiety, they and a therapist can come up with strategies to tackle what they're afraid of.

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Don't Do Too Much

"Some parents do too much for their child," she says. "They will call the teacher instead of having the kid talk to them. They won't ask their teen to do normal daily tasks." Or they will let the kid skip challenging tasks without making a plan for gradual progress. For example, "A child might not be able to do a presentation in class right now. But we'd spend a month or two working up to it - they will practise by giving the presentation to just the teacher or to a friend. So if parents are letting their kids out of those kind of tasks," without a plan for improvement, they're not doing their child any favours. "Short-term accommodations are necessary, but there has to be a plan for long-term growth. If you're typing their paper for them, you're not really protecting them at all."

Facilitate Incremental Progress

Part of getting over anxiety, says Dr Siqueland, is "facing fears step by step. You don't want take over for your kids - it decreases their competence and confidence." Help kids come up with incremental steps to their goals: "In our practice we say, 'You have to pick one thing that you're going to do this semester,'" such as making eye contact and saying hi to three people every day in the hall, or regularly going out for chips with one or two friendly kids. "It should be some small, personal, ongoing challenge. If they are in sports but they don't do much outside of just showing up, you can offer to give another teen a ride home, or stop for pizza, or offer to drive your child and a friend to the movies. Offer to facilitate these small steps."

Make a Plan, Maybe Even a Half-Arsed Plan

An anxiety reaction can feel like things are "big, global and impossible," Dr Siqueland tells me. She suggests helping your kid write down what they have to do. Get specific, and break each task down step by step. "Sometimes it is indeed overwhelming," she says. "Teens are managing impossible schedules, and you can take a step back and ask, 'Is this an impossible task?'" If a teen is juggling sports and extracurriculars and homework, things can not only seem overwhelming but actually be overwhelming. And this is where you can leverage your authority as a parent: "You have prioritise sleep, even if that means a change in the grades. The Wi-Fi can go off from 11-7. As for homework, teach them how to half-arse things. All the homework doesn't have to be perfect," says Dr Siqueland.

When to Seek Professional Help 

Exactly how much anxiety is too much? At what point should a family seek consult a medical professional?

"There are two criteria that I tell all parents," says Dr Siqueland. "First, if the teen is experiencing distress - if they say they're upset, or are having physical symptoms like headaches or stomachaches. And second, if the anxiety is limiting the things they have to do or want to do, like school attendance, or not dating, or not seeing friends," it might be time to seek professional help.

Step Off The Craziness

Dr Siqueland and I talk briefly about the huge amount of pressure a lot of kids are under to get into a "good" university. "This is my personal hobbyhorse," she says. "I do a lot of presentations [at schools] and I counsel parents and teens to step off the craziness. There's this perception that if you don't [get into a top school] it's a lost opportunity, and it's just not true. Kids can do gap years, there are state schools, there are a whole range of colleges. You're making your kid insane." She pauses. "But a lot of times the pressure is kid-driven, too." She notes that university admissions officers can tell, anyway, when a kid is playing three sports but hates them - "that they're not doing this because they're really interested and they like it".

And, she points out, a lot of the pressure is actually parent to parent, so we need to learn to manage our own anxiety too, and let kids make the decisions that work for them. Otherwise, she says, they arrive for their first year of university "never have been asked to rise to the occasion of taking care of their own life".

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